Neuromonitoring and follow-up in patients with congenital heart disease in Spain
Introduction: There is evidence of the high incidence of neurological abnormalities in patients with congenital heart disease (CHD). Despite this, perioperative neuromonitoring strategies and long-term follow-up protocols are not standardized in Spain. Objective: The aim of our study was to describe...
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Elsevier
2025-02-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2341287925000171 |
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| author | Alexandra Belfi Laia Vega Marta Aguar María Carmen Bravo Débora Cañizo Laura Díaz Rueda Marta Camprubí-Camprubí Alexandra Belfi Laia Vega Marta Aguar María Carmen Bravo Débora Cañizo Laura Díaz Rueda Cristina Fernández-García Ángela Ferrer José Manuel González Gómez Laura Ximena Herrera Castilloz Jaume Izquierdo-Blasco Begoña Loureiro María Miñambres Rodríguez Raúl Montero Yéboles M. Ángeles Murillo Pozo Esther Ocete Hita Marta Olmedilla Jódar Daniel Palanca Arias Rosa Pérez-Piaya Moreno Úrsula Quesada M. Victoria Ramos Casado Silvia Redondo Blázquez Alba Ribas Cristina Ruiz-Herguido Francisco de Asís Sánchez Martínez Amelia Caridad Sánchez Galindo Joan Sanchez-de-Toledo Eva Valverde Jose Luis Vazquez Cristina Yun Castilla Marta Camprubí-Camprubí |
| author_facet | Alexandra Belfi Laia Vega Marta Aguar María Carmen Bravo Débora Cañizo Laura Díaz Rueda Marta Camprubí-Camprubí Alexandra Belfi Laia Vega Marta Aguar María Carmen Bravo Débora Cañizo Laura Díaz Rueda Cristina Fernández-García Ángela Ferrer José Manuel González Gómez Laura Ximena Herrera Castilloz Jaume Izquierdo-Blasco Begoña Loureiro María Miñambres Rodríguez Raúl Montero Yéboles M. Ángeles Murillo Pozo Esther Ocete Hita Marta Olmedilla Jódar Daniel Palanca Arias Rosa Pérez-Piaya Moreno Úrsula Quesada M. Victoria Ramos Casado Silvia Redondo Blázquez Alba Ribas Cristina Ruiz-Herguido Francisco de Asís Sánchez Martínez Amelia Caridad Sánchez Galindo Joan Sanchez-de-Toledo Eva Valverde Jose Luis Vazquez Cristina Yun Castilla Marta Camprubí-Camprubí |
| author_sort | Alexandra Belfi |
| collection | DOAJ |
| description | Introduction: There is evidence of the high incidence of neurological abnormalities in patients with congenital heart disease (CHD). Despite this, perioperative neuromonitoring strategies and long-term follow-up protocols are not standardized in Spain. Objective: The aim of our study was to describe current clinical practice in neuromonitoring, neuroimaging and neurodevelopmental follow-up in patients with CHD in Spanish hospitals that perform paediatric cardiac surgery (PCS). Material and method: We conducted a survey by adapting a questionnaire originally developed by the European Association Brain and Congenital Heart Disease Consortium to collect data on aspects such as the implementation of perioperative neuromonitoring and the type of neuroimaging techniques and neurological follow-up performed. The questionnaire was distributed to the 19 Spanish hospitals that perform PCS. Results: We received responses from 17 centres. Eighty-eight percent performed some type of preoperative neuroimaging and 81% postoperative monitoring. The most widely used technique was transfontanellar sonography. Fifty-six percent of the centres used some form of intraoperative neuromonitoring, most frequently near-infrared spectroscopy. Nineteen percent had an established protocol for the follow-up of these patients and 13% were in the process of developing it. Conclusions: There is considerable heterogeneity in neuromonitoring, neuroimaging and neurologic follow-up practices in the management of patients with CHD in hospitals that perform PCS in Spain. These findings highlight the need to pursue a consensus in order to standardise neuromonitoring and neurologic follow-up strategies in children with CHD in Spain. Resumen: Introducción: Existe evidencia de la alta incidencia de alteraciones neurológicas en pacientes con cardiopatía congénita (CC). No obstante, en España, las estrategias de neuromonitorización perioperatorias, así como los protocolos de seguimiento no estan estandarizadas. Objetivo: El objetivo de este estudio es describir las prácticas clínicas actuales en cuanto a neuromonitorización, neuroimagen y seguimiento del neurodesarrollo en pacientes con CC en los hospitales españoles que realizan cirugía cardíaca pediátrica (CCP). Material y método: Se diseñó una encuesta adaptando un cuestionario previamente desarrollado por The European Association Brain and Congenital Heart Disease Consortium, en la que se exploraron aspectos relacionados con la neuromonitorización peri-cirugía, las técnicas de neuroimagen y el seguimiento neurológico. La encuesta se envió a los 19 hospitales españoles con programa de CCP. Resultados: De los hospitales contactados, se obtuvo respuesta de 17. El 88% de los centros realiza algún tipo de neuroimagen pre-cirugia y un 81% post-cirugía. La ecografía transfontanelar es la técnica más utilizada. El 56% de los centros utiliza alguna estrategia de neuromonitorización intraquirúrgica, siendo la espectroscopia de infrarrojo cercano la más utilizada. Solo el 19% de los centros disponen de un protocolo de seguimiento para estos pacientes y el 13% están en proceso de planificación. Conclusiones: Existe una gran heterogeneidad en las prácticas de neuromonitorización, neuroimagen y seguimiento neurológico para pacientes con CC en los centros españoles con CCP. Estos hallazgos subrayan la necesidad de avanzar hacia un consenso que permita estandarizar las estrategias de neuromonitorización y seguimiento neurológico en niños afectos de CC en España. |
| format | Article |
| id | doaj-art-7a404aaeedff48828bcea03d50c73bc6 |
| institution | DOAJ |
| issn | 2341-2879 |
| language | Spanish |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Anales de Pediatría (English Edition) |
| spelling | doaj-art-7a404aaeedff48828bcea03d50c73bc62025-08-20T03:00:50ZspaElsevierAnales de Pediatría (English Edition)2341-28792025-02-01102250373910.1016/j.anpede.2025.503739Neuromonitoring and follow-up in patients with congenital heart disease in SpainAlexandra Belfi0Laia Vega1Marta Aguar2María Carmen Bravo3Débora Cañizo4Laura Díaz Rueda5Marta Camprubí-Camprubí6Alexandra Belfi7Laia Vega8Marta Aguar9María Carmen Bravo10Débora Cañizo11Laura Díaz Rueda12Cristina Fernández-García13Ángela Ferrer14José Manuel González Gómez15Laura Ximena Herrera Castilloz16Jaume Izquierdo-Blasco17Begoña Loureiro18María Miñambres Rodríguez19Raúl Montero Yéboles20M. Ángeles Murillo Pozo21Esther Ocete Hita22Marta Olmedilla Jódar23Daniel Palanca Arias24Rosa Pérez-Piaya Moreno25Úrsula Quesada26M. Victoria Ramos Casado27Silvia Redondo Blázquez28Alba Ribas29Cristina Ruiz-Herguido30Francisco de Asís Sánchez Martínez31Amelia Caridad Sánchez Galindo32Joan Sanchez-de-Toledo33Eva Valverde34Jose Luis Vazquez35Cristina Yun Castilla36Marta Camprubí-Camprubí37Vanderbilt University School of Medicine, Vanderbilt University, Nashville, United StatesUnidad de cuidados intensivos pediátricos y neonatales, Hospital Universitari Dexeus, Grupo Quiron Salud, Barcelona, SpainUnidad de Neonatología Hospital Universitario y Politécnico La Fe, Valencia, SpainUnidad de Neonatología, Hospital La Paz, Madrid, SpainServicio Neonatologia, BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, Hospital Clínic, Universidad de Barcelona, Barcelona, SpainICare4Kits, Grupo de Investigación Cardiovascular, Institut de Recerca Sant Joan de Déu, Barcelona, SpainServicio Neonatologia, BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain; ICare4Kits, Grupo de Investigación Cardiovascular, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Corresponding author.Vanderbilt University School of Medicine, Vanderbilt University, Nashville, United StatesPediatric and Neonatal Intensive Care Unit, Hospital Universitari Dexeus, Grupo Quirónsalud, Barcelona, SpainNeonatal Unit, Hospital Universitario y Politécnico La Fe, Valencia, SpainNeonatal Unit, Hospital La Paz, Madrid, SpainDepartment of Neonatology, BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu - Hospital Clínic, Universidad de Barcelona, Barcelona, Spain. ICare4Kits, Cardiovascular Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, SpainPediatric Intensive Care, Hospital Virgen de las Nieves, Granada, SpainDepartment of Neonatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainComplejo Hospitalario Universitario A Coruña, A Coruña, SpainHospital Materno Infantil de Málaga, Malaga, SpainHospital General Universitario Gregorio Marañón, Madrid, SpainDepartment of Pediatric Intensive Care, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Neonatology, Hospital Universitario Cruces, Barakaldo, SpainHospital Clínico Universitario Virgen de la Arrixaca, Murcia, SpainPediatric Intensive Care Unit, Hospital Reina Sofía, Cordoba, SpainPediatric Intensive Care Unit, Hospital Universitario Virgen del Rocío, Seville, SpainPediatric Intensive Care, Hospital Virgen de las Nieves, Granada, SpainPediatric Intensive Care Unit, Hospital 12 Octubre, Madrid, SpainPediatric Intensive Care Unit, Pediatric Cardiology Unit, Hospital Universitario Miguel Servet, Zaragoza, SpainHM Montepríncipe, Pediatric and Neonatal Intensive Care Unit, Madrid, SpainPediatric Intensive Care Unit, Hospital Universitario Virgen del Rocío, Seville, SpainPediatric Intensive Care Unit, Hospital 12 Octubre, Madrid, SpainDepartment of Pediatric Intensive Care, Hospital Universitario Cruces, Barakaldo, SpainDepartment of Neonatology, BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu - Hospital Clínic, Universidad de Barcelona, Barcelona, Spain. ICare4Kits, Cardiovascular Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, SpainDepartment of Neonatology, BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu - Hospital Clínic, Universidad de Barcelona, Barcelona, Spain. ICare4Kits, Cardiovascular Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, SpainHospital Clínico Universitario Virgen de la Arrixaca, Murcia, SpainHospital General Universitario Gregorio Marañón, Madrid, SpainDepartment of Pediatric Cardiology, Hospital Sant Joan de Déu, Barcelona, Spain. ICare4Kits, Cardiovascular Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain. Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United StatesNeonatal Unit, Hospital La Paz, Madrid, SpainHospital Ramon y Cajal, Madrid, SpainHospital Materno Infantil de Málaga, Malaga, SpainDepartment of Neonatology, BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu - Hospital Clínic, Universidad de Barcelona, Barcelona, Spain. ICare4Kits, Cardiovascular Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, SpainIntroduction: There is evidence of the high incidence of neurological abnormalities in patients with congenital heart disease (CHD). Despite this, perioperative neuromonitoring strategies and long-term follow-up protocols are not standardized in Spain. Objective: The aim of our study was to describe current clinical practice in neuromonitoring, neuroimaging and neurodevelopmental follow-up in patients with CHD in Spanish hospitals that perform paediatric cardiac surgery (PCS). Material and method: We conducted a survey by adapting a questionnaire originally developed by the European Association Brain and Congenital Heart Disease Consortium to collect data on aspects such as the implementation of perioperative neuromonitoring and the type of neuroimaging techniques and neurological follow-up performed. The questionnaire was distributed to the 19 Spanish hospitals that perform PCS. Results: We received responses from 17 centres. Eighty-eight percent performed some type of preoperative neuroimaging and 81% postoperative monitoring. The most widely used technique was transfontanellar sonography. Fifty-six percent of the centres used some form of intraoperative neuromonitoring, most frequently near-infrared spectroscopy. Nineteen percent had an established protocol for the follow-up of these patients and 13% were in the process of developing it. Conclusions: There is considerable heterogeneity in neuromonitoring, neuroimaging and neurologic follow-up practices in the management of patients with CHD in hospitals that perform PCS in Spain. These findings highlight the need to pursue a consensus in order to standardise neuromonitoring and neurologic follow-up strategies in children with CHD in Spain. Resumen: Introducción: Existe evidencia de la alta incidencia de alteraciones neurológicas en pacientes con cardiopatía congénita (CC). No obstante, en España, las estrategias de neuromonitorización perioperatorias, así como los protocolos de seguimiento no estan estandarizadas. Objetivo: El objetivo de este estudio es describir las prácticas clínicas actuales en cuanto a neuromonitorización, neuroimagen y seguimiento del neurodesarrollo en pacientes con CC en los hospitales españoles que realizan cirugía cardíaca pediátrica (CCP). Material y método: Se diseñó una encuesta adaptando un cuestionario previamente desarrollado por The European Association Brain and Congenital Heart Disease Consortium, en la que se exploraron aspectos relacionados con la neuromonitorización peri-cirugía, las técnicas de neuroimagen y el seguimiento neurológico. La encuesta se envió a los 19 hospitales españoles con programa de CCP. Resultados: De los hospitales contactados, se obtuvo respuesta de 17. El 88% de los centros realiza algún tipo de neuroimagen pre-cirugia y un 81% post-cirugía. La ecografía transfontanelar es la técnica más utilizada. El 56% de los centros utiliza alguna estrategia de neuromonitorización intraquirúrgica, siendo la espectroscopia de infrarrojo cercano la más utilizada. Solo el 19% de los centros disponen de un protocolo de seguimiento para estos pacientes y el 13% están en proceso de planificación. Conclusiones: Existe una gran heterogeneidad en las prácticas de neuromonitorización, neuroimagen y seguimiento neurológico para pacientes con CC en los centros españoles con CCP. Estos hallazgos subrayan la necesidad de avanzar hacia un consenso que permita estandarizar las estrategias de neuromonitorización y seguimiento neurológico en niños afectos de CC en España.http://www.sciencedirect.com/science/article/pii/S2341287925000171Cardiopatía congénitaNeuromonitorizaciónSeguimiento neurológicoNeuroimagen |
| spellingShingle | Alexandra Belfi Laia Vega Marta Aguar María Carmen Bravo Débora Cañizo Laura Díaz Rueda Marta Camprubí-Camprubí Alexandra Belfi Laia Vega Marta Aguar María Carmen Bravo Débora Cañizo Laura Díaz Rueda Cristina Fernández-García Ángela Ferrer José Manuel González Gómez Laura Ximena Herrera Castilloz Jaume Izquierdo-Blasco Begoña Loureiro María Miñambres Rodríguez Raúl Montero Yéboles M. Ángeles Murillo Pozo Esther Ocete Hita Marta Olmedilla Jódar Daniel Palanca Arias Rosa Pérez-Piaya Moreno Úrsula Quesada M. Victoria Ramos Casado Silvia Redondo Blázquez Alba Ribas Cristina Ruiz-Herguido Francisco de Asís Sánchez Martínez Amelia Caridad Sánchez Galindo Joan Sanchez-de-Toledo Eva Valverde Jose Luis Vazquez Cristina Yun Castilla Marta Camprubí-Camprubí Neuromonitoring and follow-up in patients with congenital heart disease in Spain Anales de Pediatría (English Edition) Cardiopatía congénita Neuromonitorización Seguimiento neurológico Neuroimagen |
| title | Neuromonitoring and follow-up in patients with congenital heart disease in Spain |
| title_full | Neuromonitoring and follow-up in patients with congenital heart disease in Spain |
| title_fullStr | Neuromonitoring and follow-up in patients with congenital heart disease in Spain |
| title_full_unstemmed | Neuromonitoring and follow-up in patients with congenital heart disease in Spain |
| title_short | Neuromonitoring and follow-up in patients with congenital heart disease in Spain |
| title_sort | neuromonitoring and follow up in patients with congenital heart disease in spain |
| topic | Cardiopatía congénita Neuromonitorización Seguimiento neurológico Neuroimagen |
| url | http://www.sciencedirect.com/science/article/pii/S2341287925000171 |
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